Are you an OB or Midwife-type family?

Manada · March 2013

Okay - this is a bit of a vent because it's been irking me since yesterday, plus I'm curious to know how others make choices, and communicate with your care providers.

We had a pre-pregnancy consult yesterday with a high-risk OB because of some auto-immune antibodies I have which means that when we get pregnant we'll need a fetal echocardiogram to check on the baby's heart.

I used to manage a midwifery clinic so that philosophy of care is pretty ingrained in my ideas of pregnancy and birth -- but I was pretty irked at the way the OB talked to us yesterday. She wasn't rude, just not engaged at all - and seemed to have a sort of superiority thing going on, as if informed choice in our care wasn't a concern of ours, and so she was just going to tell us what would happen rather than explain what was going on and why.

I mentioned at the end that we'd probably be aiming for midwifery care, and she seemed a bit put out, but really - it opened my eyes to what we might have to come to terms with anyway if we have a midwife because we are for sure in for a few more consults with that high-risk team around this in pregnancy.

So what is your plan? Or do you have an OB or midwife now? How do you like your care provider? And if you have any communication difficulties with them - how do you maintain your own sense of self-confidence?

(am curious!)

JoySeattle · March 2013

I had an OB (that was a bit brusk, but direct, asked me my thoughts about potential plans of action, and I felt respected). We saw her for 1 early pregnancy appt as we decided on a licensed midwife. For us, the plan has always been to plan for a homebirth unless complications arose for me or baby that made hospital birth necessary. We have some great options of out of hospital midwives locally and we are very happy with our decision. I feel that our whole family is cared for and respected, C is seen as a vital member of the question-asking/decision-making. That said, if I needed to transfer care back to an OB, I'd need to find a new one as I switched insurance. I would be very dilgent about selecting an OB that was also considerate of the fact that this is my/our pregnancy and we will be making the decisions in consultation with them (except in the event of life threatening emergencies, in which case I'd trust their decisions as necessary).

I think self-confidence and self-advocacy care huge, but I also know as a dou.la that it can be more challenging for some people, in some contexts and at some points. I think being clear in your wants and needs, setting the tone early on, and asking meaningful questions doing a good job of that in most cases. There is also the benefit of having a professional dou.la to assist with those things if it comes to the point where your voice alone isn't being heard, or you could use with some processing and framing support.

Best wishes on your care providers search and relationship building!

2MamazInSeattle · March 2013

Hey!

(I just got home last night from spending the week in your snowy city Tuesday was a nice day though!!).

So - I've always been a fan of the midwifery mindset - birth is a natural process, and the caregiver is there to advise, give expert perspective, and help when you need it. The OB perspective - that birth is a medical event to be managed - has never sat well with me. That said - I think there are some amazing OB's out there and likely some crappy midwives. Based on the philosophical basis though, we are a midwife family.

We did meet with an OB who works in an office that has both midwives and OB's, thinking that the midwifery influence would 'help' - but he just talked really fast and went through checklists. He didn't examine me, but did look at the baby with a little portable ultrasound. He told me to disregard my Endocrinologist's directions and adjust my thyroid meds! Mine you, my endo is one of the best in Seattle, I've been with for years, and has been obsessive in managing my thyroid in early pregnancy.

So all that said - I had already had a midwife initial appt. scheduled, I went to her and she did a thorough exam of me, spent a lot of time with us, didn't feel rushed, etc. Overall it just felt better.

In our case, we are still having our baby in a hospital, so though I hope not to, there are drugs, OB, surgeons, etc. available. We figure this is the best case - assuming a 'regular ole birth' we'll have an unmedicated birth with a midwife; should things get complicated, everything we need to keep me and babykins safe is at the ready.

Keeping in mind most OB's show up during the last 10-15 minutes to catch the baby, it's truly the 9 months leading to birth that your caregiver is truly giving you the bulk of your care - birth is a one-time event. I'd say to make sure you are comfy for the long road of pregnancy. My thinking is, ultimately, anyone with training at the hospital can catch a baby in a normal delivery, but keeping me sane during the pregnancy is a much longer term task I definitely love the midwifery approach best.

clairmeij · March 2013

Because I changed insurance to benefit from kaiser's RE department, I was sent to kaiser's OB team when we graduated. Overall the team is pleasant and friendly, even though I feel as though they don't spend much time with each patient. Our plan all along was to switch to a local birth centre that I fell in love with way before I got pregnant at 24 weeks. The reason we waited for so long is that all of my kaiser prenatal care was covered whereas the birth centre is out of pocket. I have my first appt. on Monday. I have meet two of their midwives already though, and toured the centre and love it.

ETA midwifery family for sure.

havingaleo · March 2013

We have an OB--we really like him. He's very nurturing. The main reason we have an OB is because I am paranoid--as you may all have gathered from some of my other posts--and I am 40, so I am worried. I really did want to try a birthing tub though.

LolaBelle515 · March 2013

I suppose we are "both." I would have preferred a midwife in general because of their lower C-section rates and philosophy of care, but my wife found an OB she really really liked and since she was carrying, that is who we chose. In the end, we had a very very positive pregnancy and labor experience with the OB and her practice. I don't regret it at all, and fully support what made my wife feel most comfortable.

I do think it is possible to find OBs, even in a high-risk pregnancy, who are more open to your way of thinking. I would "shop around" if I were you, until you can find someone you are comfortable working with, for any part of your TTC and/or pregnancy process. Good luck!

mollykelley · March 2013

Hi Manada! I'm sorry you had that experience. I also feel it is so important to feel listened to and cared for. It is super important for us with TTC and we totally love our team at RE clinic. I know I will feel the need to trust the OB or MW the same way in order to feel comfortable.

When I was PG we had one appointment with midwife when I was 7 weeks. We loved her and wanted to plan a home birth with tub. We will likely go back to her when it is time, though it will be all OOP expenses. My insurance seems to like paying for super invasive procedures like IVF but not natural birth. Lol. I figure our process of making a baby is so unnatural and medical I want birth to be as natural as possible. This is all hopeful thinking, first I need my BFP!

Good luck and wishing you the very best! I still think of you as cycle buddy!!!

bundleoluv11 · March 2013

Well I'm going to say this by me been a birth care professional I truly understand when I talk to families about there care during pregnancy and they ususally know what they want and go for a midwife and they hire a doula during the pregnancy. uBut, I had two beautiful girls and I worked with OB/GYN and they were wonderful to me and my family When I lost my son (stillbirth) my OB/GYN cried with us and was so helpful and really step up and beyond the called of duty and name her daughter after me and send flowers when I got pregnant again after we lose are son. So, I love my OB/GYN now as well she did my IUI's and she is hands on with me and my partner!! But, I want to work with a midwife as well along side with my OB/GYN and I feel that it would be a great match since they know each other.

2moms2b · March 2013

I just wanted to chime in that I am sorry you had an experience like that. I have seen OB/GYN before that treat their patients as transactions and that really bothers me as pregnancy is already such as scary, emotional and beautiful process.

My recommendation is to go with what feels right for you. I would have loved to use a midwife and have a water birth (that was the original plan) but with the twins that wasn't possible. Most midwives will not even entertain or see a twin pregnancy in my area as it is immediately considered high risk. Also in the end I required a c-section so I would have been at the mercy of the on call doc.

I will say we did find an OB practice with 5 doctors that we absolutely fell in love with and I was surprised as I am pretty anti large doctor practices. It was very important for a doctor we knew to be the one to deliver the boys and this practice made sure we met all doctors (while we had one primary doctor) just in case a situation arose where we needed an immediate emergency delivery and got the doctor from the practice on call instead of ours. In our case we did need an emergency c section but our doctor came to the hospital to deliver us. He even put on an 80's dance mix during our c-section to lighten the mood.

We were always treated with respect and our questions, wishes were always discussed and answered completely. M was treated with complete respect and her questions were always answered as well. To them a two mom family was not a big deal (or at least that is how they made us feel).

Just remember you are never stuck with a doctor. If at any point you feel your care is lacking or they just don't mesh well with your style, you can change doctors. There are people on my birth month board that changed at 34 weeks! Some thought they had found the perfect doctor and then several weeks in didn't like something so they changed. You are your best advocate so don't forget that.

Also I am not sure about what is available in Canada but in my area a lot of Midwives are part of an OB practice so you can always have the care of a Midwife but the option of staying in the same practice if you need to switch to an OB for whatever reason.

I will say it is a hard transition to go to an OB from an RE as the level of care and welcome our RE had for us was so above and beyond. It was also such a personal process and they are the ones who helped us make our family. It was hard for me to let go and put my faith and trust in another team of doctors. So just be patient and keep searching until you find the best fit.

Best of luck ladies!

trisholio · March 2013

I am going to be honest and say that I was always the type of woman that hates to be in pain, I am a huge sissy and I wanted to give birth in a hospital with drugs and get it over with. But after talking about this at length with my DW, I have started to change my mind. Then today we watched "Business of being born" a documentary about giving birth in America. After watching it I now want to be pregnant like yesterday and I for the first time in my life, am considering a home birth. It really opened my eyes to a lot of things and also confidence in myself as a woman.

That being said I am not pregnant yet, but when I do get knocked up I am really hoping to have a midwife but an OBGYN has a back up plan. We are really going to start looking into a possible home birth (assuming that the pregnancy goes well and isn't high risk for any reason).

Best of luck to all of you knocked up ladies! :-) I wish you all quick and painless deliveries!!

trisholio · March 2013

I am going to be honest and say that I was always the type of woman that hates to be in pain, I am a huge sissy and I wanted to give birth in a hospital with drugs and get it over with. But after talking about this at length with my DW, I have started to change my mind. Then today we watched "Business of being born" a documentary about giving birth in America. After watching it I now want to be pregnant like yesterday and I for the first time in my life, am considering a home birth. It really opened my eyes to a lot of things and also confidence in myself as a woman.

That being said I am not pregnant yet, but when I do get knocked up I am really hoping to have a midwife but an OBGYN has a back up plan. We are really going to start looking into a possible home birth (assuming that the pregnancy goes well and isn't high risk for any reason).

Best of luck to all of you knocked up ladies! :-) I wish you all quick and painless deliveries!!

IUIBaby · March 2013

I had an OB, but next time around we might do the midwife and birthing center route!

leapgirl8 · March 2013

We didn't end up having a choice b/c very few midwives will accept a multiples pregnancy. That said, a lot of the things we were worried about with an OB (actually an MFM in our case) turned out not to be a concern b/c we live in an area of the country that is pretty progressive regarding birth options. On our hospital tour they told us that they consider birth to be a "well patient" event, and that they treat it as such and give you the maximum amount of choice and input. Stuff like being able to make your room a comfortable environment, immediate skin-to-skin contact and breastfeeding support is standard. Our experience was so good that if we choose to have a third (presumably a singleton), we would go back to that same hospital instead of pursuing the midwife route.

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